title: Chondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starting as early as 6 months after initiation of therapy: a randomised, double-blind, placebo-controlled pilot study using MRI.
abstract: OBJECTIVE
  To determine the effect of chondroitin sulphate (CS) treatment on cartilage volume loss, subchondral bone marrow lesions (BML), synovitis and disease symptoms in patients with knee osteoarthritis (OA).
  
  
  METHODS
  In this pilot multicentre, randomised, double-blind, controlled trial in primary knee OA, 69 patients with clinical signs of synovitis were randomised to receive CS 800 mg or placebo once daily for 6 months followed by an open-label phase of 6 months in which patients in both groups received CS 800 mg once daily. Cartilage volume and BML were assessed by MRI at baseline and at 6 and 12 months; synovial membrane thickness was assessed at baseline and at 6 months.
  
  
  RESULTS
  The CS group showed significantly less cartilage volume loss than the placebo group as early as 6 months for the global knee (p=0.030), lateral compartment (p=0.015) and tibial plateaus (p=0.002), with significance persisting at 12 months. Significantly lower BML scores were found for the CS group at 12 months in the lateral compartment (p=0.035) and the lateral femoral condyle (p=0.044). Disease symptoms were similar between the two groups.
  
  
  CONCLUSIONS
  CS treatment significantly reduced the cartilage volume loss in knee OA starting at 6 months of treatment, and BML at 12 months. These findings suggest a joint structure protective effect of CS and provide new in vivo information on its mode of action in knee OA.
authors.affiliation: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre, Notre-Dame Hospital, Montreal, Canada.
authors.forename: Lukas Martin
authors.initials: LM
authors.lastname: Wildi
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Raynauld
authors.forename: Johanne
authors.initials: J
authors.lastname: Martel-Pelletier
authors.forename: André
authors.initials: A
authors.lastname: Beaulieu
authors.forename: Louis
authors.initials: L
authors.lastname: Bessette
authors.forename: Frédéric
authors.initials: F
authors.lastname: Morin
authors.forename: François
authors.initials: F
authors.lastname: Abram
authors.forename: Marc
authors.initials: M
authors.lastname: Dorais
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pelletier
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000188:drug therapy* / Q000209:etiology; D002358:Cartilage, Articular / Q000473:pathology*; D002809:Chondroitin Sulfates / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D018579:Patient Selection; D013583:Synovial Membrane / Q000473:pathology; D013585:Synovitis / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D002809:Chondroitin Sulfates